In a conference room on the 12th floor of the City-County Building, a group of lawyers, paralegals and mental health professionals talk through a series of sad vignettes. Women with major depression locked up for prostitution, men with schizophrenia caught shoplifting. A man diagnosed with bipolar disorder arrested for misdemeanor trespass.

These are the people who fall through the cracks of the U.S. criminal justice system. Their mental illness contributes to their law-breaking behavior, but the court’s cure of incarceration often worsens the disease.

So many persons with mental illness who once would have been in institutional care now fill the nation’s prisons — perhaps as many as 20 percent of the record U.S. prison population — that some observers label the1980s era movement away from in-patient care of the mentally ill “re-institutionalization” instead of de-institutionalization. The collision between the courts and the mental health system happens every day, and there seems to be little authorities in either system are able to do about it.

Except for here.

The group gathered around this conference table is reviewing candidates for Marion County criminal court’s mental health diversion program, called PAIR (Psychiatric Assertive Identification and Referral). Since its creation in 1996, PAIR has taken some 500 mentally ill persons facing minor criminal charges and referred them out of the court system and into treatment. If the arrestees can meet a year’s worth of strict conditions, including complying with psychiatric treatment and not getting into any further criminal trouble, their criminal charges are dismissed.

It is no surprise to see public defenders and mental health counselors sitting at this City-County Building table pushing for diversion. Perhaps less predictable is the presence of two deputy prosecuting attorneys. Lou Ransdell introduces himself and his colleague Kathy Infanger by saying, “We are the most important people in the room.”

He laughs when he says it, but he is right.

Under Indiana law, county prosecutors have virtually unchecked discretion to file charges and to dismiss them. So it is the prosecutors who decide which defendants can get PAIR diversion — those with a case involving a weapon or serious injury, or DUI or cocaine possession, need not apply — and when they can get their cases dismissed. Why would an office whose boss inevitably gets elected on a lock-em-up promise agree to something so, well, rehabilitating?

"It takes a different philosophical point of view to deal with these cases,” says Ransdell, who has worked on the PAIR team for three and a half years. “If you get someone who is causing a problem at McDonald’s every day, or wandering around the neighborhood intoxicated or angry, it is a quality of life issue. I want to screen people into the program who can change their lives so they can stop being a problem for neighborhoods and businesses.

"This is considerably cheaper than police runs, incarceration and case after case clogging up the court system,” Ransdell says.

And the program works. PAIR advocates estimate that 80 percent of those diverted into the program successfully complete their agreements. “Which is an amazing figure,” says Mike Trent of Midtown Community Mental Health. “If you look at the rate of mentally ill people successfully completing typical probation, it is more like 20 percent.”

John M. Christ is a private criminal defense attorney who has had several clients enter into the PAIR diversion program. One mentally ill client, who committed what Christ calls “non-sensical” shoplifting acts, was severely disturbed by the experience of spending four days in the county lockup.

“The clients I’ve referred to PAIR clearly would not have been committing crimes if not for their mental health issues,” Christ says. “Since they closed Central State, I think we all see more clients with mental illness, so it’s great that the county is picking up the responsibility where the state has left off. A lot of people in the criminal justice system should be in residential care, but that option often doesn’t exist any more.”

For more information about the PAIR program, call Judy Spray of the Marion County Public Defender Agency, 327-6869.

Fran Quigley is a contributing editor to NUVO, where this article originally appeared - ...